Complications of Lupus

Topic Contents

Complications of Lupus

Topic Overview

Some people who have
lupus (systemic lupus erythematosus, or SLE) develop
complications with internal organs, such as the kidney, heart or lungs.

Living with lupus

Most people with lupus are able to
continue their usual daily activities. You may find that you need to cut back
on your activity level, get help with child care, or change the way you work
because of fatigue, joint pain, or other symptoms. You may find that you have
to take time off from daily activities entirely.

Most people with
lupus can expect to live a normal or near-normal life span. This depends on how
severe your disease is, whether it affects vital organs (such as the kidneys),
and how severely these organs are affected.

Medicines used to
treat moderate to severe lupus have side effects. It can be difficult to tell
what problems are part of the natural course of the disease and what problems
are due to effects of medicines used to control the disease.

In
the past, lupus was not well understood. People who had lupus died younger,
usually of problems with vital organs. Now that the disease can be treated more
successfully, life expectancy with lupus has increased significantly.

Birth control, pregnancy, and lupus

Hormones such as
estrogen and
prolactin are sometimes used for hormone therapy, birth control, and as part of fertility treatments. Studies do not agree on whether taking hormones increases the risk for lupus or
for lupus symptom flares. If you are thinking about taking hormones, talk to your doctor about the risks and benefits of this treatment.

Lupus doesn't typically affect a woman's ability
to conceive. But if you are having a lupus flare or are taking
corticosteroid medicines, you may have irregular menstrual cycles, making it
difficult to plan a pregnancy.

It is not clear whether women have
more lupus flares during pregnancy. But there does seem to be an increased risk
to the developing fetus.1 The risks are decreased if
the woman avoids becoming pregnant during a period of active lupus activity. So
it's a good idea for women who have lupus to use effective birth control when lupus
is active.2 If you plan to have a baby or are already
pregnant, it is very important that you and your doctor discuss
how lupus may affect your pregnancy .

Kidney problems

Kidney problems
affect many people who have lupus.
These problems usually don't cause any symptoms, but some people may
notice swelling in their legs or ankles (due to fluid retention) that they have
not had in the past. The first sign of kidney problems is often abnormal
urinalysis findings, such as protein, blood, or white
blood cells in the urine or granular or red cell casts (clumps of red blood
cells or kidney cells).

In a few cases, kidney
problems are so severe that the kidneys stop working properly or fail
completely. Depending on how severe kidney damage is, treatment can include
strong medicines to control the lupus,
kidney dialysis, or a kidney transplant.

Heart problems

Inflammation of the sac around the heart (
pericarditis). This is the most common lupus-related heart
problem.

Hardening of the arteries that supply blood to the heart
muscle. People with lupus are at increased
risk for plaque deposits in arteries (
atherosclerosis) that may cause coronary artery
disease. They are also likely to develop plaque deposits at an earlier age than
people who do not have lupus.

Diseases of the heart valves. A few people
with lupus may have slightly thickened heart valves, which makes them more
susceptible to infections of the damaged valves (
endocarditis),
blood clots, or
heart failure. Some people with damaged heart valves
may need surgery to replace the valves.

Inflammation of the heart
muscle (
myocarditis), which is uncommon but may lead to
problems with the heartbeat or heart muscle. The heart may beat too fast, too
slow, or irregularly.

Lung problems

About 1 out of 3 people who have lupus develop
inflammation of the tissue around the lungs.1
Sometimes this causes no symptoms. At other times it causes painful
breathing, coughing, or chest pain that is worse with a deep breath (
pleurisy). Many people with lupus have chest pain when
they breathe. When this pain is not caused by pleurisy, it is commonly caused
by inflammation of the chest muscle, cartilage, or ligaments, or of the joints
that connect the ribs to the breastbone (costochondral joints). In these cases,
the lungs may not be affected.

Less common lung problems
with lupus include fever, cough, and inflammation of the lung tissue
(acute lupus pneumonitis). Some people with lupus produce an antibody that
causes their blood to clot more easily (antiphospholipid antibody). These people may be at risk for clots
in the lung (
pulmonary emboli). An unusual
complication is the buildup of fluid in the lungs (
pulmonary edema), caused by heart or kidney problems.

Blood-related problems

Blood-related problems are
common in people who have lupus, but they do not always cause detectable
symptoms. These problems, which in a few cases are severe and even
life-threatening, include:

Changes in red blood cells, which carry oxygen;
white blood cells, which fight infection; and platelets, which help the blood
clot.

Anemia caused by the destruction of red blood cells (
hemolytic anemia), low white blood cell count (leukopenia), or low platelet count (
thrombocytopenia). Anemia can be caused by both lupus
and the medicines used to treat it.

Production of antibodies that
attack certain blood-clotting factors, causing the blood to clot easily. These
antibodies are produced by about 1 out of 3 people who have lupus.1 They can cause a condition, called
antiphospholipid antibody syndrome , which can lead to
mild or severe blood-clotting complications.

Nervous system problems

Headaches, which are common but are
usually related to stress and tension.
Migraine headaches occur in many people who have
lupus.

Nervous system problems that cause vision disturbance,
dizziness, muscle weakness in the face, arms, or legs, or loss of temperature
or pain sensation in the feet, hands, arms, or legs (cranial or
peripheral neuropathy ).

Seizures. They may be caused by problems with blood
pressure, infections, or inflammation in blood vessels in the
brain.

Mental health problems

Psychosis, a mental-behavioral disorder in which a
person may have delusions (firmly held but false beliefs) or hallucinations
(false perceptions) or both, is seen in some people who have lupus. It can be caused by the
disease or by medicines such as tranquilizers, corticosteroids, or narcotic
pain relievers.

Manic behavior, including unusually high levels of
energy and activity, difficulty sleeping, and irritability, can occur as a
result of
corticosteroid treatment for lupus. It is usually not
serious and goes away when the medicine is discontinued.

Digestive system problems

Problems in the digestive
system are not common with lupus but may include:

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the
Terms of Use .
How this information was developed to help you make better health decisions.

Individual and family medical and dental insurance plans are insured by Cigna Health and Life Insurance Company (CHLIC). In Arizona, individual HMO plans are insured by Cigna HealthCare of Arizona, Inc. Group health insurance and health benefit plans are insured or administered by CHLIC, Connecticut General Life Insurance Company (CGLIC), or their affiliates (see a listing of the legal entities that insure or administer group HMO, dental HMO, and other products or services in your state). Group Universal Life (GUL) insurance plans are insured by CGLIC. Life (other than GUL), accident, critical illness, and disability plans are insured or administered by Life Insurance Company of North America, except in NY, where insured plans are offered by Cigna Life Insurance Company of New York. All insurance policies and group benefit plans contain exclusions and limitations. For availability, costs and complete details of coverage, contact a licensed agent or Cigna sales representative. This website is not intended for residents of New Mexico.

Selecting these links will take you away from Cigna.com. Cigna does not control the linked sites' content or links. Details